Vol 23, No 5 (2019)
- Year: 2019
- Articles: 13
- URL: https://jps-nmp.ru/jour/issue/view/17
ORIGINAL ARTICLES
AN UNSUTURED MESENTERY DEFECT AFTER COLON GRAFT FORMATION IN ESOPHAGOPLASTY IN CHILDREN
Abstract
Purpose. To decrease the number of complications at the intra-abdominal stage of total esophagoplasty in children by leaving a mesentery defect unsutured after the graft formation. Material and methods. 27 children with atresia (4) and scar contraction (23) of the esophagus had esophagoplasty with a colon left-side graft on a vascular pedicle including a. colicamed; a.colicasin and the arcade between the first sigmoid artery were ligated and cut. The graft was placed behind the sternum in the antiperistaltic position. A “window” in the mesentary of the transverse colon was left unsutured after the graft formation. Basic techniques for examination - X-ray and endoscopy. An anastomosis “end of the esophagus to the side of the colon graft” was always formed at the neck level. Results. Due to the unsutured mesentary of the transverse colon, surgeons avoided all intra-abdominal complications which may develop, if the mesentary is sutured. The right side of the colon remained intact ; neck-anastomosis fistulas were seen only in 2 (9%) patients.
Russian Journal of Pediatric Surgery. 2019;23(5):238-242
238-242
LAPAROSCOPIC PROCEDURES IN CHILDREN WITH PANCREATIC PSEUDOCYSTS
Abstract
Introduction. Pancreatic pseudocysts are encapsulated fluid sacs in the omentum having no epithelial lining; they appear in the pancreas after injury and inflammation. Recently, there has appeared a trend to treat pancreatic pseudocysts with laparoscopic surgical interventions. The article describes laparoscopic treatment of pancreatic pseudocysts in 10 children. Objective. To evaluate the effectiveness of laparoscopic interventions in children with pseudocysts in the pancreas. Material and methods. In 2013-2018, 10 laparoscopic surgeries in children, aged 4-17 (5 boys and 5 girls), with pancreatic pseudocysts were performed at the department of pediatric surgery in the Russian Medical Academy of Continuous Professional Education. Indications for surgery were: pancreatic pseudocysts having diameter more than 6 cm and wall thickness more than 3-4 mm, no effect after the conservative therapy , cyst formation more than 3 months, persistent pain syndrome. Results. The choice of a surgical technique was defined by pseudocyst etiology and location. The children had six laparoscopic cystoeunoanastomoses, two partial cystectomies with a distal pancreatojejunoanastomosis and two partial cystectomies with a longitudinal pancreatojejunoanastomosis when the cyst was formed at the chronic pancreatitis. No intraoperative complications were seen. Early postoperative complications occurred in 2 patients: an external pancreatic fistula at the drainage site (1) and intestinal obstruction (1) at the level of the intestinal anastomosis. Conclusion. Laparoscopic surgeries in children with pancreatic pseudocysts are effective and less traumatic. The laparoscopic technique allows to make a complete revision, to perform sequestrnecrectomy , if necessary, as well as to take the material for histological examination and to ensure a reliable long-term drainage.
Russian Journal of Pediatric Surgery. 2019;23(5):243-247
243-247
PRACTICAL ASPECTS OF LAPAROSCOPIC ADRENALECTOMY IN CHILDREN WITH BENIGN ADRENAL TUMORS
Abstract
Introduction. Despite of almost 30-year world experience in mini-invasive adrenalectomy in non-oncologic pediatric patients, this issue remains not fully understood and systematized in the domestic literature. Material and methods. Our work is based on 67 laparoscopic adrenalectomies performed in 65 patients, aged from 3 months to 17 years, with predominantly benign neoplasms. Despite of a thorough preoperative examination of each patient, we met malignant neoplasms in 7 cases: 4 - adrenocortical cancer and 3 - neuroblastomas (further they were treated by oncologists). Location of the neoplasms was as follows: right-sided - 31, left-sided - 26, bilateral - 8 (6 patients out of them had bilateral simultaneous removal). Average size of the removed formations was 4.65 ± 1.29 cm (maximum 12 cm). Results and discussion. The vast majority of detected adrenal neoplasms are removed. Exceptions may be neoplasms less than 4 cm in diameter with the native density less than 10 HU by computed tomography; however, they should be actively monitored by specialists. If a malignant process is suspected, patients should be examined more thoroughly and should be treated in specialized hospitals. Nowadays, a minimally invasive and safe surgical treatment of neoplasms in the adrenal glands depends on the experience and trainings of surgeons and anesthesiologists, as well as on the equipment in the operating room. A key to the successful treatment of patients with benign adrenal neoplasms is a specific attention to curative peculiarities in such patients as well as an adequate sequence of actions during laparoscopic adrenalectomy in its main stage, namely, ligation of the central adrenal vein.
Russian Journal of Pediatric Surgery. 2019;23(5):248-253
248-253
254-257
REVIEWS
LAPAROSCOPIC HEMINEPHRECTOMY IN CHILDREN (A REVIEW)
Abstract
The laparoscopic technique for the treatment of duplex kidney anomaly became popular thanks to the efforts of G. Jordan and B. Winslow, who in 1993 successfully performed the world’s first laparoscopic heminephrectomy in a child. This operation has made its way into the world of surgical methods that have great potential for improving postoperative patient recovery and cosmetics, asserting the progress of pediatric endourology. Since the first report of laparoscopic heminephrectomy, a minimally invasive approach has gained popularity, and in some advanced surgical centers it has completely replaced open surgery in the treatment of urinary tract abnormalities. To date, there are several studies that demonstrate the safety and feasibility of laparoscopic heminephrectomy in children; nevertheless, the use of such an approach in the pediatric population is limited. Other endosurgical techniques for treating duplex kidney anomaly include retroperitoneoscopy, single-port laparoscopy and robotic surgery. The choice of endosurgical heminephrectomy technology is determined in accordance with the patient’s age, possession of technical capabilities and personal experience of the surgeon. In the literature, there is still a relative lack of evidence of the safety and effectiveness of endosurgical operations designed to remove the affected kidney segment in children. The purpose of the scientific review is to analyze the results of laparoscopic heminephrectomy in children and present its strengths and weaknesses, based on data that exist today in modern scientific literature.
Russian Journal of Pediatric Surgery. 2019;23(5):264-269
264-269
THE ETIOLOGY AND PATHOGENESIS OF HIP JOINT ARTHRITIS IN CHILDREN. A LITERATURE REVIEW
Abstract
Arthritis in children is a group of diseases that are encountered by various specialists. It is a pediatrician, who starts the diagnostic search, in most cases. The definition “arthritis of the hip joint” implies a number of pathologies. In the article, the researcher discusses the basic aspects of epidemiology, etiology and pathogenesis of such forms of arthritis as septic, transient, reactive as well as the arthritis in orthopedic pathologies.
Russian Journal of Pediatric Surgery. 2019;23(5):270-275
270-275
HEALTH ORGANIZATION
258-263
ANNIVERSARY
PEDIATRIC SURGERY - THE MATTER OF ALL LIFE (ON THE 100TH ANNIVERSARY OF STANISLAV YA. DOLETSKY, ACADEMICIAN OF THE RUSSIAN ACADEMY OF MEDICAL SCIENCES)
Russian Journal of Pediatric Surgery. 2019;23(5):232-237
232-237
CLINICAL OBSERVATIONS
TREATMENT OF CHILDREN WITH ATRESIA OF THE BILE DUCTS (CASE-HISTORIES)
Abstract
The article describes two cases of children operated on for the biliary atresia (BA) on days 56 and 33 of their life. One child after the Kasai surgery had liver transplantation at the age of 1 year and 2 months because of the deterioration of his liver synthetic function which was manifested by the clotting factor deficiency. Another child (5-month old) does not need any transplantation at present. The article defines “red trackers” for the immediate examination of a child for biliary atresia.
Russian Journal of Pediatric Surgery. 2019;23(5):276-280
276-280
281-284
A CLINICAL OBSERVATION OF THE COMBINATION OF OMPHALOCELE WITH ATRESIA OF THE SMALL INTESTINE OF TYPE 3A IN A NEWBORN
Abstract
The authors present a clinical case of an extremely rare combination of the congenital defect of the front abdominal wall as omphalocele, congenital evolution defect of the small intestine - atresia of the small intestine type III, agenesis of the ileum with ileocecal angle and malrotation syndrome. Surgical treatment was as follows: T-shaped ileocolic «end-to-side» anastomosis with an unloading colostomy by the Bishop-Koop technique and intestinal intubaton till the Treitz ligament. Outcomes of such surgical correction are good.
Russian Journal of Pediatric Surgery. 2019;23(5):285-287
285-287
HISTORY OF MEDICINE. MEMORABLE DATE
AN UNNAMED FRIEND
Russian Journal of Pediatric Surgery. 2019;23(5):288-289
288-289
50-YEAR JUBILEE OF THE CHAIR OF PEDIATRIC SURGERY IN THE BASHKIR STATE MEDICAL UNIVERSITY
Russian Journal of Pediatric Surgery. 2019;23(5):290-291
290-291